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目的探讨研究中性粒细胞/淋巴细胞比值(NLR)与阻塞性睡眠呼吸暂停综合征(OSAS)程度的关系。方法将158例按照睡眠期呼吸暂停低通气指数(AHI)情况分为4个组,分别为正常对照组(n=39)、轻度OSAS组(n=38)、中度OSAS组(n=41)和重度OSAS组(n=40),此外对重度OSAS组中的31例实施持续气道正压(CPAP)治疗3个月,对该31例进行CPAP治疗前后对比。比较的血细胞参数包括白细胞、中性粒细胞、淋巴细胞、中性粒细胞/淋巴细胞比值(NLR)。结果 NLR的组间比较显示重度OSAS组(3.29±1.19)显著高于正常对照组(1.71±0.69)、轻度OSAS组(1.70±0.71),中度OSAS组较正常对照组和轻度OSAS组亦明显增高(均为P<0.05),而正常对照组与轻度OSAS组间及中度OSAS组与重度OSAS组间差异无统计学意义(P>0.05)。重度OSAS患者CPAP治疗前后对比结果显示治疗后NLR(1.98±0.81)较治疗前NLR(3.28±0.62)显著降低(P<0.05)。此外4个组中NLR与睡眠期AHI是呈正相关的(r=0.758,P=0.034),同时最低氧饱和度与AHI呈负相关(r=-0.179,P=0.012)。结论 NLR可随着OSAS程度的加重而增高,因而可能作为一新的指标用来辅助评估OSAS患者体内炎症反应的严重程度。
Objective To investigate the relationship between neutrophil / lymphocyte ratio (NLR) and obstructive sleep apnea syndrome (OSAS). Methods Fifty-eight patients were divided into four groups according to the sleep apnea-hypopnea index (AHI). They were normal control group (n = 39), mild OSAS group (n = 38), moderate OSAS group 41) and severe OSAS group (n = 40). In addition, 31 patients in severe OSAS group were treated with continuous positive airway pressure (CPAP) for 3 months. The 31 patients were compared before and after CPAP treatment. Comparative blood cell parameters include leukocytes, neutrophils, lymphocytes, neutrophil / lymphocyte ratio (NLR). Results Comparisons between two groups showed that the OSAS group (3.29 ± 1.19) was significantly higher than that of the normal OSAS group (1.71 ± 0.69) and mild OSAS group (1.70 ± 0.71) (P <0.05). There was no significant difference between the normal control group and the mild OSAS group and the moderate OSAS group and the severe OSAS group (P> 0.05). The comparison of the results of CPAP before and after treatment in patients with severe OSAS showed that the NLR (1.98 ± 0.81) after treatment was significantly lower than that before treatment (3.28 ± 0.62) (P <0.05). In addition, there was a positive correlation between NLR and AHI during sleep (r = 0.758, P = 0.034). The lowest oxygen saturation was negatively correlated with AHI (r = -0.179, P = 0.012). Conclusion NLR may increase with the severity of OSAS and may be used as a new index to help assess the severity of inflammatory reaction in OSAS patients.